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End of Life health services on Vancouver Island are improving ... slowly

Coordination between the Province, regional health authorities, various hospice societies, and communities is helping improve the availability and quality of end of life services for Vancouver Island residents.

A priorities update report from Island Health (formerly the Vancouver Island Health Authority) regarding Island Health’s End of Life (EOL) program was released in June, which analyzes and makes recommendations on data regarding EOL care in the region.

“Unfortunately, many people who are dying may end up in acute care during the last weeks of life when that is neither their care preference, nor their need,” according to the report, and it reevaluates the program’s priorities to mitigate that fact.

Based on the report’s findings, 45 per cent of the approximately 6,000 people per year who die on Vancouver Island of natural causes die in an acute care location, such as a hospital, compared to 27 per cent who end their lives in “Residential Services,” and 19 per cent who die at home, “with support from Home and Community Care.”

Seven per cent pass away in a palliative care facility or hospice.

“The ability to deliver compassionate, timely and appropriate services to patients with a variety of medical needs and personal preferences is a key priority for Island Health,” said Dr. Leah MacDonald, medical director for Island Health’s EOL program. “We are extremely pleased to be partnering with community organizations including hospice societies, physicians and other clinical experts to expand and improve our end-of-life care services.”

The “population-based” EOL system being adapted by Island Health is modelled on an Australian framework, which, according to the report, “is an internationally recognized framework for EOL care that is designed to ensure that services are directed to support the right patient at the right time,” through a comprehensive and collaborative approach.

The framework is designed for ease of mobility between these services, as well as having them integrated within the health care network more efficiently. The question on a number of people’s mind’s, however, surrounds the lack of bed-space for those in palliative care situations, which is one of the reasons why large percentages of the population are dying in acute care facilities when they die of natural causes, despite that not being their wish.

In September of 2006, the B.C. government launched a public health discussion to have British Columbians “take an active role in the discussion and help shape the future of our public health system.” The comments cited in the official report of that engagement make it clear that British Columbians want more options for EOL care.

“We end up shutting people into acute care and are missing an opportunity for people to come into an environment that is more responsive and appropriate for end-of-life,” and, “people are dying in hospitals because they do not have options/services available,” are representative of the feelings of the public, according to the report.

The June 2014 report indicates that it is the goal of Island Health to double the number of hospice beds available by 2020, in response to the public’s concerns.

“Island Health recognizes each community’s desire for hospice beds,” the report says. “We also recognize that most communities would like to see these beds open faster than what the strategy outlines.”

Island Health currently has 32 hospice beds, none of which are in Campbell River, which the new report says will be receiving three of the 32 projected additional beds. These three beds will be integrated into the health care system sometime in 2016-17, according to the projections. For more information on Island Health’s current and future plans in terms of hospice-palliative and EOL care, go to viha.ca/pal_eol or contact your primary healthcare provider.

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